Going under the knife

Well, the results are in.

I had my MRI yesterday and was fortunate that the Dr that ordered it had a cancellation today so I was able to find out the results and discuss options.

I've got a herniated disc at the first sacrum nerve root with associated trauma.

So it's not going to just "get better". I could elect conservative treatment but a) the possibility of recurrence will always be looming over my head and b) there's the possibility of nerve degradation and loss of function.

So I've decided to go the surgical route. Exactly what that means is undefined at this point with options ranging from a microdiscectomy to fusion. My Dr thought the former was most likely. I've got a referral to a neurosurgeon at U-W who specializes in spinal surgery (that's all he does). The challenge now is getting the initial consult scheduled and then getting the surgery scheduled. Having made the decision to go ahead, I just want to get on with it.

How does the rest of the year lay out? Pretty hard to say given that I don't know what surgery I'm going to have but assuming it's the microdiscectomy it looks something like this:

• Initial consult - 3-4 weeks (middle to end of July)
• Surgery - 3-4 weeks after that (early to mid August)
• Recovery - 4-6 weeks after surgery (mid-September to early October)

It's likely that the recovery is progressive i.e., I should be able to walk almost immediately and perhaps resume easy cycling within a few weeks. It might be that the recumbent is a better choice for the initial recovery but I don't know at this point.

In the interim, I've got a prescription for prednisone to reduce the inflammation in my back. Assuming it's successful, I can ride but he suggested the recumbent only to avoid the acute angle in my back and resulting stress associated with riding a regular bike.

What about the future? If I have the surgery am I "cured"?

Well, no. Assuming a microdiscectomy and assuming it's successful, there is the possibility of re-injuring the same disc although it's significantly reduced. There's also the possibility that the stress will just move up to the next vertebra and I'll have the same problem there although this is not likely. It turns out the rest of my back is in pretty decent shape.

This does mean I'm on the aggressive core strengthening and stretching train for life. Assuming I do that and am not a complete dufus (which admittedly is a bit of a stretch) I should be able to resume riding brevets including long ones and I should be able to do them on a regular bike.

Oh, and one interesting aside. Remember that "severe soleus strain" I had early in the year? He was 100% certain that was my back. I've looked at my logs from the time and I made no mention of back pain but as I sit here typing this, my left calf is hurting, my left foot is numb and I don't have any back pain at all. The possibility had never even occurred to me until he said it but the sensation I'm experiencing is remarkably similar to what I had early in the year.

So as I said, having made the decision to have surgery - let's get on with it!

Stay tuned!

More idle speculation about the future

It's now been two weeks since my last ride. To date, I've had three acupuncture/PT appointments. I have an MRI scheduled tomorrow and Drs appointments on July 6th and 13th. As things stand, I'm no longer having the "OMFG bolt of lightning, I can't stand it" kind of pain (which, believe me, is a very good thing) but do have residual pain in my back, almost continuous tightness in my left calf and numbness in my left foot (I walk with a pronounced limp). When I sit for any length of time my left hamstring starts to get a burning sensation which gradually gets worse until I have to stand.

I'm no longer doing any kind of strengthening, only stretching with focus on relieving pressure on the disk (inversion table) and stretching my hip flexors which are one of the culprits causing my problem.

I've continued to ponder the future, especially with respect to doing longer rides. I'm by nature an optimist so I tend to favor the rosier scenario:

• I didn't do anything overtly stupid like try to pick up a car so the current problem is more a result of doing more than my back muscles could handle (N.B. by "back muscles" I mean lower back, glutes, hamstrings, etc) rather than trauma.
• Given that, it's not likely that I have e.g., a herniated disk. Instead, the muscles just got excessively overworked, locked up and compressed my spine on the nerve.
• Given that, it's likely that with continued therapy and rest the problem will resolve itself and I'll be no worse (or no better) than I was before.

So in this best case scenario, I'm off the bike for some period of time then basically return to normal service with the addition of more rigorous and regular core strengthening and an increased focus on stretching post-ride.

But in the event I'm wrong, I've started thinking about a less rosy scenario where I did actually do some permanent damage that's not going to just "go away". And while we're being negative, let's roll with it and assume no amount of PT and non-invasive therapies make any difference and the only alternative is surgery (gulp).

I've said in the past that I wouldn't have surgery. I'll say now that if the way I feel today is as good as it gets there's no way I'd want to live the rest of my life like this. I'm in just enough pain that I'm really not able to do much. I've learned how to move to avoid aggravating my back and am so limited in what I can do that I'm barely functional.

So if I go under the knife, what does that mean for my riding future?

Well, certainly I'm done for 2020. It's hard to imagine any form of back surgery that wouldn't require 3-6 months of recovery. Ideally, if the surgery is successful I'll go back to business as usual. But if I'm limited in any way, it might mean no more long rides and it's this scenario I've been pondering of late.

Would I continue as RBA if I'm not able to ride my own brevets? Right now, the answer is no and I think that's unlikely to change.

Would I continue to try and ride the longest distances that my back would allow? I'm not sure. To be honest, right now I feel like I'm sitting on a keg of dynamite playing with matches. It might go off any second. It's not a good feeling.

One "good thing" about my back issues historically is that they've been localized to my back with no sciatic nerve involvement. Over the years and through some fair amount of painful experimentation I learned the several things that would cause me back problems and learned to avoid them.

But this is a whole 'nuther thing. I never want to have this again. Ever.

So I'm less inclined to skate toward the edge of the ice in the hope it won't crack.

Let's hope that we're going down the "rosy scenario" path.

Stay tuned!

Contemplating the future

As I write this, it's been a week since my back went to hell. This is the first time there's been sciatic involvement in my back pain and it's a whole new level of hell that I'm exploring. Although not bedridden, I'm essentially a cripple unable to do even the simplest things pain free. Putting on shoes, getting in/out of the car, getting in/out of bed, etc., are all exercises in suffering.

I've got several appointments scheduled that I hope bring some diagnostic clarity and pain relief. My self diagnosis is either sciatica or piriformis syndrome, more likely the former, and I'm getting an MRI to hopefully make a more definitive diagnosis.

In the meantime, I'm not certain what to do from an exercise/rehab point of view so I'm basically trying different things and letting the pain guide me. To this point, none of them have provided any relief but they haven't made it worse either so in absence of a better plan I'm going to continue. Here's what I've been doing:

• Daily walk of 1.5-3 miles at a relatively slow pace. Not a "power walk" by any means.
• Hamstring/calf stretch. The hamstring stretch is done laying on the floor with my back straight and looping a towel over my foot then pulling on the towel to raise and stretch my leg. The calf stretch is the traditional one of leaning at an angle like you're pushing something.
• 2 x 25 reps "bicycles" where I lay on the floor with my back straight, lift my leg with my knee bent and touch the knee with the opposite elbow.
• Bridge. I'm taking it easy with this one as it occasionally causes pain the hamstring. No more than one minute, less if I get a twinge in the hamstring.
• Ice/heat several times daily.
• NSAID's (naproxin) just before bedtime.

Assuming that this does eventually resolve itself either due to treatment or the passage of time, I've started thinking about what the future holds vis-a-vis cycling and randonneuring.

As I said in my previous post, right now a long brevet this year seems unlikely. I'll continue to hold out hope that it's possible but am not counting on it. Right now my goal is to simply get back on the bike and ride at JRA pace. My plan initially is to ride the trainer since it has the advantage that if I'm on it and start to feel pain I can stop instantly without having to worry about getting home.

But what about after I'm able to ride pain free on the trainer for e.g., an hour or more? And a related question, do I continue to ride a conventional DF bike, the recumbent, alternate between both?

Although there are lots of people who ride recumbents exclusively due to back or neck pain (my wife being one of them), as I've said in the past, I'm basically a "DF guy". Having said that, if it's a choice between the agony I'm currently experiencing or never riding again then it's as close to a no brainer as anything gets and I've always been good at no brainer decisions.

The recumbent is not without trade-offs though. As I've noted previously, their performance profile is sufficiently different from a DF that if I use one for randonneuring it's likely that I'll do the majority of my brevets solo. On one hand, I go to every brevet mentally prepared to ride the whole thing solo and I've done very long brevets e.g., London-Edinburgh-London completely solo. This has been in no small part due to my determination to "ride my own ride" and not go faster/slower/stop longer/stop less than I want which is often part of riding with others. On the other hand, when I do encounter someone who is simpatico both in terms of their riding speed and time off the bike, I've really enjoyed having someone else to ride with. This is less likely to happen with the recumbent.

The second trade-off is more practical: a recumbent is a real bitch to pack, transport and reassemble. I'm a good mechanic so I don't find it intimidating but the need to disassemble it almost completely makes flying with a recumbent especially off-putting. Further, the smallest and lightest case I've been able to find that the Cruzbike will fit in weighs 30 pounds empty and the Cruzbike alone weighs about 24 pounds. Lugging that plus whatever attendant luggage I need through airports, taxis, etc., especially with a back that is "somewhat suspect" might mean that I just never do it.

I'm toying with the idea of riding the Cruzbike semi-exclusively for the remainder of the year and perhaps doing the Cracker Swamp on it. The Cracker Swamp is ideal for a couple of reasons: 1) I can drive to it and probably would anyway given coronavirus and air travel and 2) the terrain in Florida is pretty much right in the recumbents wheelhouse. I don't know whether that would mean I'd be on the recumbent permanently for brevets or would go back to a DF. Actually, at this point given that my longest ride on the recumbent has been 100K, I don't even know that I could do a longer brevet on it.

So, lots to think about. Right now, I'd just like to be able to tie my shoes.

Stay tuned!

And that's a wrap

Perhaps a bit melodramatic but at this point it looks like 2020 is over as far as brevets are concerned, at least longer ones.

Here's the sad story...

My adoring public of regular readers will know that I've had ongoing back issues that have caused several DNF/DNS beginning in 2014. To recap the year thus far:

• I was injured (severe Soleus strain) in late January/early February (update 7/14: nope, not the Soleus, the back)
• Gradually increased the mileage: 528 in February, 546 in March, 677 in April
• Gradually increased the distance but longest rides this year are in the 60-80 mile range
• Started doing hill repeats/Everesting in mid-April. Ramped up to longer efforts with 4X repeats, 6X repeats, 10x repeats and the first serious effort on April 22 with 24 repeats on Bunker Hill.
• Repeated the longer hill repeats/Everesting rides on May 2nd and May 15th.
• In the interval between April 22 and May 15th did four rides of 60-70 miles.
• Since May 15th I've been focused more on doing some longer rides (no more hill repeats) and did 5 rides of 60 miles or longer in the last 3 weeks.

On Saturday, June 6th I did a 70 mile ride that included 4 longer climbs and had 3,822 feet of climbing overall (55 feet/mile). Not flat but not egregiously hilly either. The ride concluded on Wildcat Mountain and I did that at what I'd describe as a moderately hard effort (8:15 vs a PR of 7:48). It should be noted that my "PR" was set in the middle of a 300K so it's not as though I was out there chasing KOM's.

The next day, my back was a little sore. Not debilitating by any means, just a dull ache and (sadly) nothing really out of the ordinary. I did a short, easy 18 mile ride on the Cruzbike.

On Monday, my back really hurt and my glutes and left hamstring felt tight. Ice, heat, gentle stretching a couple of times that day.

On Tuesday, all hell broke loose. I couldn't even get out of bed without extreme pain. By far the worst I've ever had with my back. The pain is actually localized in my left glute right at the hip/femoral joint but my back also hurts as does my hamstring/calf. I'm basically a cripple and am hobbling about. Strenuous activity (tying my shoes, getting up from a chair, even sitting) is agonizing.

As I write this on Friday, I've spent the last three days doing the ice/heat/gentle stretching routine several times a day. No improvement at all to this point.

My self diagnosis (more on that anon) is piriformus syndrome or extreme pressure on the disc. Although I've spent a lot of time looking at my ride log for the year, it really doesn't seem to me that I've overdone it or tried to go to far or do too much climbing too soon. All of the harder efforts are preceded by shorter, easier rides.

But it's hard to argue with the result and I can't identify any other possible causes. Usually, when I hurt my back I can point to doing something stupid (lifting something heavy, being bent over for a long period of time) or an ultra hard effort on the bike. There was nearly a month between my last Everesting ride and my ride this past Sunday and although I did some longer rides in the interim, none of them were what I'd call even moderately hard efforts.

Despite Marcia and I spending the morning on the phone, the earliest Drs appointment I can get is almost 6 weeks from now (cue "Health Care in the U.S. is horrifically broken" rant) so I'm going to have to continue to self diagnose and treat.

At this point, the rosiest scenario I can envision is that I'm doing short, easy rides in 1-2 weeks working up to 30-40 mile rides in July and perhaps longer ones after that.

And I think that's the best case scenario.

So 2020 is over as far as randonneuring is concerned. I might be able to do a 200K in the fall - maybe - but it's hard for me to see how I can do e.g., my 1000K in September or the Cracker Swamp (assuming it's held) in November. I'd also begun planning for an SR600K at the end of September and I'd say that's probably not in the cards either.

I hope I'm wrong and this is a matter of a bit of rest and a return to normal but that seems wildly optimistic right now.

Stay tuned!

Thinning the herd

OK, first world problem time.

I've got too many bikes. I didn't count them and usually when someone asks me how many I have I only think of road bikes and not e.g., my fat bike, my errand bike (a Soma Double Cross with fenders, rack, flat pedals, etc, that I ride into town on errands) my recumbents, etc.

Counting those (which I've not done), I'm pretty sure the first digit would be a "2".

Out of space.

But worse. Like anyone who has accumulated things over a long period of time, whenever I bought a new bike I usually (though not always) sold a bike that was the least favorite in the fleet. Do that long enough and you end up with a collection that you really love.

And that's where I'm at. Every bike I have is one that has survived the winnowing process numerous times. I love 'em all.

But...

For better or worse, I can't stand to see something sit around unused. Despite the fact that I've ridden 10K+ miles per year for a long time there are bikes that are getting 1-2 rides a year. This bugs me.

Even worse, no matter which bike I choose to ride on a given day there are more than a dozen bikes that I really love that I'm not going to ride that day.

A first world problem to be sure.

So, time to part company and sell some of the kids.

First to go was my Bachetta CA 2.0. In truth, I never really loved this but it filled a need. I rode it when I hurt my back or just to do something different. But I bought the Cruzbike late last year and prefer riding that so off it goes.

Next up, the "Rando Kirk". I own two Kirks that were custom made for me and this one wasn't. I really loved it though. Big tires, fenders, rack, front bag, very nice ride. The thing is though, I'm not really into that style of bike (low trail, front bag, etc). I bought it thinking I would use it on brevets and I did use it on a few shorter ones (300K or less) but whenever I had a 600K longer brevet to do, another bike got the call. Gone.

Next up, the Calfee Tetra Pro. I've got two other Calfee's (a Bamboo and a Tetra Adventure) and this one just wasn't getting ridden. I've got a ton of miles on it over the years, rode across Iowa on it 4 times (RAGBRAI plus riding out to the start), etc., and always loved the way it rode. But it wasn't custom made for me, several other bikes occupy the same "space" in terms of ride quality, functionality, etc. Gone.

Next up, the Specialized Roubaix disc. I generally used this one on brevets in the mountains where I wanted the security of disc brakes. It's light, fast, comfortable. However, it's an "off the rack", as opposed to custom, bike and I recently took delivery of a custom bike that incorporates the best features of three of my bikes, including this one, so it's surplus. Sold.

And now we're "getting down to the seed corn" which is an expression my farming uncle used when you were talking about real issues. He grew up during the depression. When times were tough and they'd eaten everything they'd put by for the winter the only thing that was left was the seed for next years crop.

The next one to sell was my Calfee Adventure. I really liked the flexibility that this bike offered with its ability to run 650b or 700C wheels, disc brakes and easy gearing. It was a great riding bike but a bit on the heavy side and its main differentiator (ability to use different wheelsets) was subsumed by the new bike so it became surplus.

And my final Calfee is on the block and will likely sell. This is a Bamboo Pro and I really loved this one. The ride was "typical Calfee" which I characterize as "all day comfort" and I spent a lot of time on the details of the bike getting it just right: leather bar tape that matches the Brooks saddle perfectly; brass rivets on the saddle and the pièce de la rèsistance: wooden bottle cages! I never did long rides on it, this was more about a relaxed right to a restaurant to have lunch but it always brings back memories of nice rides on sunny days. Going to miss it but, like all the others, it wasn't getting ridden.

And next was my Mapei Colnago. This is IMHO one of the top 5 most beautiful production bikes ever made with its classic paint job and its hydro formed titanium tubes - especially that top tube! I looked for one in my size for years before I found this one and it's in beautiful shape. Although it doesn't have them on in the pictures, I ran it with Ambrosio Nemesis tubular wheels - just like Johan Museeuw at Roubaix! Well, just like it except for the rider. The bike was surprisingly comfortable for a race bike and handled just like a race bike should: scalpel precise and every watt put into the pedals moved you down the road. Lovely bike.

And one that hurts a bit. I bought this filet brazed Columbus Max Landshark from the person who had it built. He bought the tubeset for it while on a trip to Italy and took it to John Slawta to have it built. I've always loved riding it, the details of the frame and yes, the paint job. But, in keeping with my heuristic of "if it wasn't custom for me and isn't getting ridden" it's expendable. I've owned it for 16 years and it's hard to let it go.

And a couple of "while I'm at it" sales. Marcia is no longer able to ride an upright bike and is "all recumbent, all the time" so these have been hanging in the shed for 10 years. Pretty much gave them away but the new owners will hopefully enjoy them for years to come.

Although it's hard to believe, still a couple more to go. We've got Marcia's custom made S&S coupled Kish Ti bike to sell and I've got a Serotta Coeur d'Acier fixed gear that I'm thinking of selling (on the fence about that one). The heuristic I'm using is that I'm keeping the ones that were custom made for me, plus a few more that fill a particular niche e.g., the Cruzbike and the fixed gear is definitely a niche.

 

And one that's tough to let go. I did LEL and a number of other long brevets on this one. I love the ride, it's light, carries everything I need for a 1200K and is just fun to ride. But, as I said above, it wasn't custom made for me. I commissioned a custom bike that encapsulates the best features of this one plus two of the other ones above (the Calfee and the disc Roubaix) so all three of them were effectively surplus. Hate to see this one go. Here's a shot of it kitted out for LEL, 22 lbs as shown including all the gear I used on the ride.

 

 

 

Hoping to get under 10.